The semen analysis is the first test to evaluate the man for infertility. Semen collection is a simple, non-invasive process done at home or on-site at our IVFMD Irving or Arlington infertility center.
Complete semen analysis has the following parameters:
The normal semen volume is 2-4 ml. Low volume can result from dehydration or faulty collection technique. Persistent low volume (< 1 ml) can indicate retrograde ejaculation, a condition in which the semen flows backward into the bladder during ejaculation.
The normal sperm concentration is 20 million per ml of semen. The concentration of less than 10 million/ml usually requires in vitro fertilization (IVF) with sperm injection (ICSI). Sperm concentration is a critical factor.
At least 50% of sperm must be motile in order for the sample to be normal. However, progressive motility > 20% is usually sufficient for intrauterine insemination, provided that the sperm count is adequate. Progressive motility < 10% usually requires IVF with ICSI. Sperm motility is a critical factor.
Using the Kruger strict criteria, the structure of the sperm can be rigorously evaluated. Normal semen has at least 4% of sperm with perfect morphology. Morphology values of 2%-3% are ‘subnormal’ but can still lead to pregnancy without requiring IVF. Morphology of 0-1% may require IVF/ICSI.
Assesses the ability of sperm to move forward. Sperm have to move forward in order to reach the egg and to successfully penetrate the shell of the egg for fertilization. The grading system for progression varies among laboratories.
Should results suggest an abnormal semen analysis and require further evaluation of a reproductive urologist and our infertility center can refer you to the appropriate specialists in the Dallas, Irving, and Arlington areas.
Special Male Testing
Sperm count and sperm motility remain two of the most useful indicators of a man’s fertility potential. Additional tests, however, can be used to evaluate sperm capability and recover the healthiest sperm for fertilization.
Anti-Sperm Antibody (ASA)
Under normal condition there is a natural barrier between blood and semen. The immune cells in your blood consider sperm as foreign agents and would make antibodies to neutralize them whenever there is an encounter.
Antibodies that bind to the tail of the sperm can cause sperm to become entangled with each other and unable to swim forward. More ominously, antibodies that bind to the sperm head can prevent sperm from fertilizing the egg.
Conditions that can cause breakage of the semen-blood barrier and lead to formation of sperm antibodies include infections of the male reproductive organs (such as epididymitis and prostatitis), groin injury, or male surgery such as vasectomy reversal.
We routinely check for the presence of antibodies in the semen. Antibodies that attach to the tail can impair sperm motility while those bound to the head can prevent fertilization. The presence of significant anti-sperm antibodies usually means IVF and ICSI as treatment.
The Halo Test: Checking Sperm DNA Integrity
A routine semen analysis can provide important information about male fertility, most notably sperm motility and concentration. It does not, however, reveal information about the integrity of the sperm’s DNA. Several factors can damage sperm DNA:
Exposure to chemicals
Free radicals from normal metabolism
For some couples, sperm DNA fragmentation causes serious problems, including decreased fertilization rates and miscarriages. Identifying fragmented DNA can help show the cause of many fertility issues- and the Halo Test can help identify sperm DNA fragmentation.
Research has shown that broken DNA in sperm does not disperse after acid denaturation. Normal sperm DNA, on the other hand, disperses after special acid treatment to produce a halo of DNA chromatin around the sperm head–a clear picture that is easy to identify. The Halosperm test makes clear use of this property.
First, sperm are exposed to a colored agent that stains the DNA within each sperm capsule. Then, acid treatment makes the sperm membrane leaky. DNA is released quickly through the leaky membrane, almost like a coiled spring that has suddenly been released. If the DNA coil is broken, on the other hand, it won’t leak as readily through the sperm membrane, often remaining within the sperm head.
Checking the Results
During the Halosperm test, sperm that do not show the sperm halo are assumed to contain broken DNA. If 30% or more of the sperm in the sample contains fragmented DNA, the sample is considered abnormal. Couples then have a foundation for understanding what could cause their fertility problems and can then make decisions accordingly.
Microfluidic Technology: A New Method to Select the Best Motile Sperm
Sperm quality can have a big impact when it comes to fertility. High-quality, very motile sperm can increase the odds of IVF success, decrease the rate of birth defects, and improve the fertility potential of male offspring. It’s important, therefore, to choose the highest-possible quality sperm to fertilize eggs in order to increase the odds of successful conception and decrease the chances of future issues.
Most commonly, motile sperm are isolated from a semen sample through gradient centrifugation. First, fresh semen is washed and spun in a test tube. The most active sperm can then swim through the layer of filtering media. This method, however, ignores several of the natural barriers that sperm go through on their way to successfully fertilize an egg.
Now, there’s a new method that can help improve sperm selection, allowing fertility specialists to get the best sperm out of each sample. Microfluidics technology offer exciting new methods that can improve sperm selection. With microfluidics, minute amounts of fluid are able to pass through microchannels that measure less than a milliliter in diameter. Through these narrow channels, fluid flows at an even pace. The particle it carries can be carefully separated according to their unique characteristics.
In many industries, microfluidics can be used to separate suspending particles within a fluid. Now, it’s making its way into fertility clinics, making it possible to select the best sperm from a semen sample to fertilize the egg. With the best sperm, there is an increased chance of successful pregnancy and a decreased rate of birth defects.
Zymot- Sperm Selection Technology
ZymotTM is a newly-available commercial kit that uses microfluidic technology to sort sperm. First, a fresh semen sample is collected. Then, the semen is pushed gently into a chamber. Sperm are allowed to swim through a filter membrane that contains micropores. Eventually, the sperm able to pass through the membrane are collected and used for fertilization.
More Like Nature
Using microfluidics comes closer to allowing science to mimic the process nature uses to choose the best sperm as they swim through the female reproductive system. During natural conception, sperm must swim through the microchannels of the cervix, uterine lining, and tubes before they can meet the egg at the end of the tube. By using microfluidics, fertility clinics can sort sperm almost as effectively as nature.
Microfluidics technology offers a number of key advantages:
Superior quality sperm
High DNA integrity
All of these characteristics make the sperm a better fit for fertilization. At IVFMD, men who have sperm with high DNA fragmentation, shown through an abnormal Halosperm test, or sperm with severely abnormal morphology can benefit from this type of testing.
PICSI: Selecting the Best Slow Moving Sperm for ICSI
Microfluidics technology can help select optimal sperm as they move through microchannels. In some cases, however, it might not offer optimal support for all fertility problems–especially in the case of severe sperm hypomotility. Sperm can be viable and healthy but lack the ability to swim forward–especially if they are extracted directly from the testes.
In standard ICSI, sperm with normal appearance are arbitrarily selected for injection into the egg. ICSI can improve the rate of fertilization in case of low sperm count or motility, but it cannot ensure delivery of sperm with functional competency or determine whether they carry intact DNA. Sperm may look perfectly normal, but fail to fertilize or have fragmentations in its chromosomes that can lead to the formation of an abnormal embryo, which can increase the rate of miscarriage or the potential for birth defects.
Under natural conditions, sperm must bind to a protein called hyaluronan on the surface of the egg before the egg can be fertilized. Studies show that sperm able to bind to the hyaluronan tend to be mature and have a higher likelihood of containing undamaged DNA. In ICSI, however, this process is often bypassed.
How PICSI Can Help
PICSI helps select the best sperm for the ICSI process. It mimics the natural selection process that occurs during natural fertilization.
First, sperm are added to a Petri dish with a small circle coated with hyaluronan. After a period of incubation, the unbound sperm are washed off to reveal the sperm that adhered to the hyaluronan surface. The bound sperm are then used for the ICSI process, since they are more likely to lead to a successful pregnancy.
If you have male fertility challenges, the fertility specialists at IVFMD can help. Contact us today to learn more about the new technologies we can use to better identify potential fertility challenges, prevent them, and increase your odds of successful pregnancy.